Provider Demographics
NPI:1790755742
Name:UNITED SEATING AND MOBILITY
Entity Type:Organization
Organization Name:UNITED SEATING AND MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AND LICENSURE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-447-7515
Mailing Address - Street 1:805 BROOK ST STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3431
Mailing Address - Country:US
Mailing Address - Phone:314-447-7500
Mailing Address - Fax:314-447-7830
Practice Address - Street 1:2030 N HIGHWAY 360
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1423
Practice Address - Country:US
Practice Address - Phone:817-377-2225
Practice Address - Fax:817-377-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07088917332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145456301Medicaid
TX10006343OtherAMERIGROUP
TX251910864OtherGREAT WEST LIFE & ANNUITY
TX276581OtherAETNA NATIONAL HMO
TX017600-01OtherPACIFICARE OF TX
TX1444655-03OtherCSHCN NON-CUSTOM
TX145457101OtherSUPERIOR HEALTH PLAN
TX531032OtherBCBS OF TX
TX10465OtherPARKLAND COMMUNITY HEALTH
TX141330100OtherUS DEPT. OF LABOR
TX1444655-02OtherCSHCN
TX144465504Medicaid
TX145457101Medicaid
TX407109OtherHUMANA CHOICE CARE
TX7282299OtherAETNA NATIONAL NON-HMO
TX017600-01OtherPACIFICARE OF TX
TX145456301Medicaid